What is Nicotinic Acid: How It Works, Its Effect On Heart

Nicotinic acid is a form of niacin that can lower cholesterol. Nicotinamide is another form but has no effect on cholesterol. Nicotinic acid is different from nicotine that is found in cigarette (addictive substance found in tobacco). Some traces of nicotinic acid are found in some foods. But the quantities are insufficient to lower cholesterol levels. Only about fifteen to thirty-five milligrams of niacin is obtained by most people from foods, in daily diet. About sixty times that amount of nicotinic acid is required to help lower cholesterol. About 0.5 to 0.75 grams a day is the usual dosage required, with a recommended maximum of 1.2 grams daily.

In some cases even upto six grams a day has been prescribed. Nicotinic acid is available even without a prescription, but large doses should be taken only under medical supervision. Acipimox (Olbetam) is a derivative of nicotinic acid that can be prescribed.

How Does Nicotinic Acid Work?

Liver is the organ where nicotinic acid is supposed to influence. It interferes with the manufacture of cholesterol in different ways and mechanisms that are not well understood. When nicotinic acid has effect on the liver, it leads to decreased production of triglyceride-rich VLDL cholesterol. And since VLDL cholesterol is eventually converted to LDL cholesterol, nicotinic acid reduces both LDL cholesterol and triglyceride level.

If the cholesterol level is higher in the beginning, then more reduction in the cholesterol will be observed. In people with total cholesterol of 240mg/dL or higher one might observe a ten to twenty percent drop in total cholesterol and in LDL cholesterol levels. The reduction can be compared to levels that were achieved with normal doses of 20 to 40 mg a day of lovastatin, another drug.

Homocysteine and methylmalonic acid are two proteins that are associated with heart disease. And nicotinic acid reduces blood levels of these proteins just like folic acid.

Nicotinic Acid Effect On Heart

Nicotinic acid has the greatest HDL raising effect than any other drug. The doses are in grams and it increases HDL cholesterol levels by an average of twenty to thirty-five percent. It is highly beneficial, because according to studies the risk of coronary heart disease decreases by two to three percent for every 1mg/dL increase in HDL cholesterol levels. By increasing HDL and reducing LDL levels, nicotinic acid can improve people’s HDL to total-cholesterol ratio. According to doctors this ratio is best indicator of one’s risk of developing heart disease.

Nicotinic Acid and Cholesterol

Experts are not in favor of drug therapy (using nicotinic acid) for people with normal total or LDL cholesterol levels but low HDL. According to them, exercise can raise HDL so why take drugs unnecessarily.

Nicotinic acid has been fairly impressive in reducing the risk of heart disease. One study suggested that nicotinic acid helps to protect against heart disease not only when it is being used but also long after it has been stopped. No other drug has been able to do this. A follow-up on this was conducted over ten years. After the initial five year study ended individuals who took two grams of nicotinic acid a day had twenty percent less coronary heart disease than another group who had taken a placebo.

Nicotinic acid was first found to lower cholesterol in the nineteen fifties and it has been extensively used for all these years. Since it has been around for a while, most of its side effects are known. Something called the niacin flush is the most common side effect. One will experience warmth, flushing and itching usually on the face and upper body about half an hour after one takes it. The effect continues for fifteen to thirty minutes.


  1. ZH said:

    My LDL level is 134, HDL is 40, and Cholesterol is 197, triglycerides 150. What should I do to reduce my cholesterol?

    October 9, 2014
    • PUP said:

      Your cholesterol and LDL is on higher side. You have not mentioned your age. However, you should regularly walk for half hour in the morning or evening. Walking is good exercise as it increases metabolism and thus excess of cholesterol is utilized by the body. Also if you are smoking stop it. Reduce consumption of alcohol if you are drinking. Eat unsaturated fat items in your diet. Avoid eating food containing saturated fats. Eat less oily and fast the fried food. Eat flaxseeds, use olive oil in cooking. Avoid eating red meat instead poultry and lean meat is preferable. Follow it for three months and after that test blood for cholesterol.

      October 10, 2014

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